"Salvage Use" of Recombinant Factor VIIa After Inadequate Haemostasis in Complex Cardiac Surgery
Recruitment status was Recruiting
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Purpose
Aims and Hypotheses:
This randomised placebo controlled study will test the hypothesis that Recombinant Activated Factor VII (rVIIa) will improve haemostasis after an inadequate response to conventional therapy in complex cardiac surgery.
Major bleeding is still of concern in complex cardiac surgery. It has been shown to be associated with poorer patient outcome and results in the consumption of resources (hospital costs, manpower and blood bank reserves). This study has the potential to provide evidence that rVIIa can reduce transfusion requirements and improve patient outcome in a problematic aspect of complicated cardiac surgery.
The objective is to conduct a multi-centre randomised placebo controlled study that has been designed to scientifically evaluate the treatment of post bypass coagulopathy in the association with complex cardiac surgery. The trial design is based on clinical practice that has evolved over 2 years at the Austin Hospital during which 38 patients have received open label administration of rVIIa. There is currently no published RCT in this area and there is no TGA approval for the use of rVIIa for this indication.
| Condition | Intervention | Phase |
|---|---|---|
|
Myocardial Ischemia Blood Coagulation Disorders Coronary Artery Disease Heart Valve Diseases |
Drug: Recombinant Activated Factor VII |
Phase 3 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Safety/Efficacy Study Intervention Model: Parallel Assignment Masking: Double-Blind Primary Purpose: Treatment |
| Official Title: | "Salvage Use" of Recombinant Activated Factor VII After Inadequate Haemostatic Response to Conventional Therapy in Complex Cardiac Surgery - a Randomised Placebo Controlled Trial |
- Adequate haemostasis to enable chest closure after administration of trial medication without the need for further intervention to improve coagulation.
- Percentage of cases that haemostasis after first administration of coagulation factors alone
- Assessment of surgical field after administration of trial medication
- Time to closure of chest after administration of trial medication
- Transfusion requirements in post bypass period in theatre
- Transfusion requirements in ICU first 12 hours
- Mediastinal drainage in ICU first 12 hours
- Coagulation study results at various sample times
- Requirement for chest re-exploration
- Ventilation duration in ICU
- Duration of stay in ICU
| Estimated Enrollment: | 40 |
| Study Start Date: | June 2005 |
| Estimated Study Completion Date: | June 2008 |
Show Detailed Description
Eligibility| Ages Eligible for Study: | 18 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Patients with scheduled cardiac surgery undergoing the following procedures
- Double valve replacements or repair.
- Major thoracic aortic surgery including hypothermic circulatory arrest or descending aortic reconstruction.
- Valve repair or replacement in the setting of endocarditis
- Complex procedures requiring cardiopulmonary bypass duration anticipated to exceed 180 minutes in patients aged ³70 years
Exclusion Criteria:
- Patient unable to give informed consent
- Patient refusal
- Allergy to rVIIa
- Allergy to aprotinin or prior exposure within 6 months
- Pre-existing congenital coagulopathy
- Pre-existing hypercoagulable state
- Patients in inclusion criteria whose actual bypass time does not exceed 180 minutes
- Unresolved surgical bleeding
Contacts and Locations| Contact: Peter McCall, FANZCA | 61 3 94965000 ext 3800 | peter.mccall@austin.org.au |
| Contact: stephanie j Poustie, MPH | 61 3 94965000 ext 3800 | stephanie.poustie@austin.org.au |
| Australia, Victoria | |
| Austin Health | Recruiting |
| Melbourne, Victoria, Australia, 3084 | |
| Contact: Peter McCall, FANZCA 61 3 94965000 ext 3800 peter.mccall@austin.org.au | |
| Contact: Stephanie J Poustie, MPH 61 3 94965000 ext 3800 stephanie.poustie@austin.org.au | |
| Principal Investigator: Peter McCall, FANZCA | |
| Principal Investigator: | Peter McCall, FANZCA | Staff Anaesthetist |
More Information
Publications:
| ClinicalTrials.gov Identifier: | NCT00214656 History of Changes |
| Other Study ID Numbers: | H2005/02047 |
| Study First Received: | September 14, 2005 |
| Last Updated: | September 14, 2005 |
| Health Authority: | Australia: National Health and Medical Research Council |
Keywords provided by Austin Health:
|
Cardiac surgical procedures Surgical blood loss Surgical haemostasis Factor VIIa Anaesthesia |
Additional relevant MeSH terms:
|
Heart Valve Diseases Blood Coagulation Disorders Hemostatic Disorders Coronary Artery Disease Myocardial Ischemia Coronary Disease Ischemia Hematologic Diseases Vascular Diseases Cardiovascular Diseases |
Hemorrhagic Disorders Heart Diseases Arteriosclerosis Arterial Occlusive Diseases Pathologic Processes Hemostatics Coagulants Hematologic Agents Therapeutic Uses Pharmacologic Actions |
ClinicalTrials.gov processed this record on May 23, 2013